The present invention relates to a surgical operating apparatus which can perform therapeutic treatment, such as incision, resection or coagulation, of a living tissue by making use of composite energy of ultrasonic and high-frequency waves, and can also perform therapeutic treatment by making use of high-frequency waves.
Jpn. Pat. Appln. KOKAI Publication No. 2007-50181 (patent document 1) and Jpn. Pat. Appln. KOKAI Publication No. 2008-11987 (patent document 2), for instance, disclose general examples of an ultrasonic operating apparatus which can perform therapeutic treatment, such as incision, resection or coagulation, of a living tissue by making use of ultrasonic and can also perform therapeutic treatment by high-frequency waves.
In this apparatus, a proximal-side operation section is coupled to a proximal end portion of an elongated insertion section. An ultrasonic transducer which generates ultrasonic vibration is provided in the operation section. A treatment section for treating a living tissue is provided at a distal end portion of the insertion section.
The insertion section has an elongated circular tubular sheath. A rod-shaped vibration transmission member (probe) is inserted in the sheath. A proximal end portion of the vibration transmission member is detachably attached to the ultrasonic transducer via a screw-type coupling section. Ultrasonic vibration, which is generated by the ultrasonic transducer, is transmitted to a probe distal end portion at the distal end side of the vibration transmission member.
In the treatment section, a jaw is disposed to be opposed to the probe distal end portion. A proximal end portion of the jaw is rotatably supported on a distal end portion of the sheath via a support shaft. A driving member for driving the jaw is inserted in the sheath so as to be axially advancible/retreatable. A proximal end portion of a jaw body is coupled to a distal end portion of the driving member via a coupling pin.
The operation section is provided with an operation handle. In accordance with the operation of the operation handle, the driving member is axially advanced/retreated. In interlock with the operation of the driving member, the jaw is opened/closed relative to the probe distal end portion.
At this time, a living tissue is held between the probe distal end portion and the jaw in accordance with the closing operation of the jaw. In this state, ultrasonic vibration from the ultrasonic transducer is transmitted to the probe distal end portion on the treatment section side via the vibration transmission member. Thereby, using ultrasonic wave, therapeutic treatment, such as incision, resection or coagulation, of the living tissue is performed.
Electrodes for high-frequency treatment are formed on the probe distal end portion and the jaw. A high-frequency current is supplied, as needed, to at least one of the probe distal end portion and the jaw of the treatment section.
As shown in FIG. 26, there is a case in which the probe distal end portion is formed in a substantially J-shaped curved shape in accordance with an object of therapeutic treatment. FIG. 26 shows a distribution of a stress acting in the probe distal end portion. In the probe distal end portion of such a curved shape, a stress due to ultrasonic vibration tends to concentrate at a proximal end side position of the curved shape, as indicated by an arrow P in FIG. 26.